<!--
  ========================LICENSE_START=================================
  screenit-web
  %%
  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
  %%
  This program is free software: you can redistribute it and/or modify
  it under the terms of the GNU Affero General Public License as published by
  the Free Software Foundation, either version 3 of the License, or
  (at your option) any later version.
  
  This program is distributed in the hope that it will be useful,
  but WITHOUT ANY WARRANTY; without even the implied warranty of
  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  GNU General Public License for more details.
  
  You should have received a copy of the GNU Affero General Public License
  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  =========================LICENSE_END==================================
  -->
<html xmlns:wicket="http://wicket.apache.org">
<wicket:panel>
        <fieldset>
            <div class="row-fluid">
                <div class="span12">
                    <legend>Specifieke contactinformatie</legend>
                </div>
            </div>
            <div class="row-fluid">
                <div class="span12">
                    <table class="table table-bordered table-condensed">
                        <thead>
                        <tr>
                            <th></th>
                            <th>DK</th>
                            <th>BMHK</th>
                        </tr>
                        </thead>
                        <tbody>
                            <tr>
                                <td>Telefoonnummer</td>
                                <td><input wicket:id="regioBvoContactGegevensDk.telefoon" class="input-large" type="text"></td>
                                <td><input wicket:id="regioBvoContactGegevensBmhk.telefoon" class="input-large" type="text"></td>
                            </tr>
                            <tr>
                                <td>E-mail</td>
                                <td><input wicket:id="regioBvoContactGegevensDk.email" class="input-large" type="text"></td>
                                <td><input wicket:id="regioBvoContactGegevensBmhk.email" class="input-large" type="text"></td>
                            </tr>
                            <tr>
                                <td>Postbusnummer</td>
                                <td><input wicket:id="regioBvoContactGegevensDk.postbusnummerAdres.huisnummer" class="input-small" type="text"></td>
                                <td><input wicket:id="regioBvoContactGegevensBmhk.postbusnummerAdres.huisnummer" class="input-small" type="text"></td>
                            </tr>
                            <tr>
                                <td>Postbusnummer postcode</td>
                                <td><input wicket:id="regioBvoContactGegevensDk.postbusnummerAdres.postcode" class="input-mini" type="text"></td>
                                <td><input wicket:id="regioBvoContactGegevensBmhk.postbusnummerAdres.postcode" class="input-mini" type="text"></td>
                            </tr>
                            <tr>
                                <td>Postbusnummer plaats</td>
                                <td><input wicket:id="regioBvoContactGegevensDk.postbusnummerAdres.plaats" class="input-large" type="text"></td>
                                <td><input wicket:id="regioBvoContactGegevensBmhk.postbusnummerAdres.plaats" class="input-large" type="text"></td>
                            </tr>
                            <tr>
                                <td>Antwoordnummer</td>
                                <td><input wicket:id="regioBvoContactGegevensDk.antwoordnummerAdres.huisnummer" class="input-small" type="text"></td>
                                <td><input wicket:id="regioBvoContactGegevensBmhk.antwoordnummerAdres.huisnummer" class="input-small" type="text"></td>
                            </tr>
                            <tr>
                                <td>Antwoordnummer postcode</td>
                                <td><input wicket:id="regioBvoContactGegevensDk.antwoordnummerAdres.postcode" class="input-mini" type="text"></td>
                                <td><input wicket:id="regioBvoContactGegevensBmhk.antwoordnummerAdres.postcode" class="input-mini" type="text"></td>
                            </tr>
                            <tr>
                                <td>Antwoordnummer plaats</td>
                                <td><input wicket:id="regioBvoContactGegevensDk.antwoordnummerAdres.plaats" class="input-large" type="text"></td>
                                <td><input wicket:id="regioBvoContactGegevensBmhk.antwoordnummerAdres.plaats" class="input-large" type="text"></td>
                            </tr>
                            <tr>
                                <td>Informatie openingstijden</td>
                                <td><div wicket:id="clientPortaalVrijeTekstContainerDk"><textarea wicket:id="regioBvoContactGegevensDk.clientPortaalVrijeTekst" maxlength="256"></textarea></div></td>
                                <td><div wicket:id="clientPortaalVrijeTekstContainerBmhk"><textarea wicket:id="regioBvoContactGegevensBmhk.clientPortaalVrijeTekst" maxlength="256"></textarea></div></td>
                            </tr>
                        </tbody>
                    </table>
                </div>
            </div>
        </fieldset>
</wicket:panel>
</html>
